Stroke or Transient Ischemic Attack

Stroke and transient ischemic attack (TIA) both result from the interruption of blood flow of the cerebral artery which supplies a specific area of the brain. Both of these conditions are also referred to as a CVA (cerebrovascular accident). Death from stroke is the third leading cause of death in the United States. Stroke implies a PERMANENT interruption in blood flow to a specific area of the brain. A transient ischemic attack is a TEMPORARY interruption in blood flow (duration of symptoms is less than 24 hours). Blockage of the cerebral arteries, which supply the brain, most often occurs secondary to blood clots that are released from one of the carotid arteries in the NECK. Carotid arteries, which have been narrowed by the progressive effects of atherosclerotic vascular disease, tend to form blood clots. These clots can travel through the blood stream (embolize) and be deposited in the cerebral circulation. There they can block a smaller caliber blood vessel, depriving the brain cells in that area of oxygen. It is the lack of oxygen (ischemia), to that specific area of the brain that is responsible for the varied symptoms of stroke (see below). The effects of atherosclerotic vascular disease in the carotid arteries are the most common cause for stroke. However, a stroke can also occur if a blood clot embolizes from a another clot forming source, the heart. This can occur as a complication of acute myocardial infarction, or in some cases, a cardiac arrhythmia (atrial fibrillation). The risk factors for stroke are essentially the same as those for the development of atherosclerotic vascular disease.

STROKE AND TIA RISK FACTORS

1. DIABETES

2. HYPERTENSION (high blood pressure)

3. FAMILY HISTORY FOR STROKE

4. PRIOR STROKE HISTORY

5. HIGH BLOOD CHOLESTEROL

6. SMOKING

7. OBESITY

8. CARDIAC ARRHYTHMIA (atrial fibrillation)

STROKE AND TIA SYMPTOMS

1. CONFUSION

2. SLURRED SPEECH

3. INABILITY TO TO SPEAK

4. VERTIGO (spinning sensation)

5. NUMBNESS TO AN ARM, LEG, OR HALF OF THE FACE

6. WEAKNESS TO AN ARM, LEG, OR HALF OF THE FACE

7. DIFFICULTY WALKING (falling to one side only)

8. DOUBLE VISION (actually seeing two of one object)

9. LOSS OF VISION IN ONE EYE (like a "shade" coming down over the eye)

IMPORTANT: ARM and LEG WEAKNESS or NUMBNESS should occur on the SAME side. Evaluation will include history and physical examination to document the presence of any neurologic deficits listed above. CT-scanning of the brain can (in most cases) reveal the acute stroke. MRI scanning of the brain has also been a useful diagnostic tool. The carotid angiogram is a special x-ray that shows the extent of blood vessel narrowing in the carotid vessels. Those with significant narrowing may be candidates for surgical intervention (see below). Newer imaging technology, SPECT scanning, is beginning to be applied in the treatment of these patients and may provide earlier detection of stroke in some cases. Treatment may include medications to anticoagulate (thin) the blood (e.g. warfarin, aspirin, Ticlid, and Persantine) and dissolve clots (e.g. heparin, streptokinase). Patients with a cardiac arrhythmia will require management of their heart condition first, with the administration of additional anticoagulation at the discretion of their physician. Studies show that surgery (carotid endarterectomy) performed on the diseased carotid arteries BEFORE a stroke has occurred, can decrease the incidence of a major stroke. Physical rehabilitation of the stroke patient by a trained professional is an important part of ongoing care.

REMEMBER

1. To lessen the risk of stroke, follow a diet low in fats and cholesterol.

2. Have your cholesterol and lipoprotein levels checked routinely.

3. If you have high blood pressure or diabetes, allow your doctor to monitor you closely. Get involved in the management of your own disease through continued education (such as this product).

4. Don't smoke.

5. Avoid becoming overweight (obesity).

6. Before starting any exercise program, discuss the program with your physician.

7. There is evidence which suggests that taking 1 baby aspirin each day can decrease your risk of TIA and stroke. See your physician prior to starting anynew mediations.

Hope this article will provide you information about stroke or transient ischemic attack.

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